Lung Transplantation in Infants and Children - Indications, Surgical Techniques, and Special Considerations

Abstract

Lung transplantation (LTx) in infants and children has its roots in the adult LTx experience. The first LTx was performed by Hardy (Chapter 18, Figure 9) et al. [1] in 1963 on a patient with squamous cell carcinoma of the lung (Chapter 45). The patient lived for 17 days and died of renal failure. The autopsy results showed intact anastomoses. For the next 17 years there were numerous failures by those who attempted to repeat Hardy’s feat until 1981, when Reitz (Chapter 66, Figure 5) et al.[1] accomplished the first heart-lung transplant. Then in 1983, Joel Cooper (Chapter 45, Figure 1) et al.[1] performed a successful single lung transplant. These advances were mainly due to the introduction of cyclosporin and improved bronchial anastomotic techniques, namely bronchial wrapping with an omental pedicle. These events mark the beginnings of pulmonary transplantation, and the lessons learned were applied to the pediatric heart-lung and lung transplant population in the late 1980s[4],[5].